Corone P, Lévy A, Hallali P, Davido A, Wyler Y, Corone A
Consultation de médecine, Groupe hospitalier Pitié-Salpêtrière, Paris.
Arch Mal Coeur Vaiss. 1989 May;82(5):779-84.
A longitudinal study of a 32-year period (1954-1987) involving 2038 patients with congenital heart defects followed by the same physician yielded 54 cases of infective endocarditis (IE). Complex cyanogenic cardiopathies were particularly exposed to the risk of infection (8.2 IE for 1000 patient-years), then came ventricular septal defects (2.4), tetralogy of Fallot (2.3), aortic stenosis (2.0) and atrioventricular canal (1.7). The risk was smaller in patients with Eisenmerger complex (1.2), persistent arterial canal (1.4) and coarctation (0.7). Patients under 10 years of age (16.7%) were less affected than young adults in the 20-29 years age-group (33.4%). The organisms most frequently isolated were streptococci (42%); staphylococci ranked second (23%). Less common organisms were found in 14% of the cases, and blood cultures were negative in 21%. Systemic prophylaxis with penicillin V, introduced 16 years ago, seems to have almost halved the incidence of infective endocarditis due to penicillin-sensitive organisms.
一项为期32年（1954年至1987年）的纵向研究，涉及2038例先天性心脏缺陷患者，由同一位医生随访，共发现54例感染性心内膜炎（IE）。复杂的发绀型心脏病尤其容易受到感染风险的影响（每1000患者年有8.2例IE），其次是室间隔缺损（2.4例）、法洛四联症（2.3例）、主动脉瓣狭窄（2.0例）和房室管畸形（1.7例）。艾森曼格综合征患者（1.2例）、动脉导管未闭（1.4例）和主动脉缩窄患者（0.7例）的风险较小。10岁以下的患者（16.7%）比20至29岁年龄组的年轻人（33.4%）受影响小。最常分离出的病原体是链球菌（42%）；葡萄球菌位居第二（23%）。14%的病例中发现了较不常见的病原体，21%的血培养结果为阴性。16年前引入的青霉素V全身预防措施似乎已使对青霉素敏感的病原体所致感染性心内膜炎的发病率几乎减半。
